In the course of a surgical procedure blood vessels and other structures must often be ligated, or tied-off, and divided between two such ligatures. Dividing the vessel between two ligatures prevents the cut ends of the vessel from bleeding. These ligatures are simply lengths of silk thread or other suture material. When this procedure takes place in small confines or deep areas inaccessible to the operator's hands various instruments or "clamps" are used to pass the ligatures under the vessel.
In the current method Operator A, the primary surgeon, dissects or separates the surrounding tissues away from the vessel to create enough space for a right-angle clamp to be placed under the vessel. The tips or jaws of this right angle clamp extend beyond the vessel and are kept in an open position to await passage of the ligature from Operator B, the assisting surgeon. Operator B is handed a clamp whose jaws hold one end of the ligature to be passed. The other end of the ligature is free. Operator B grasps his clamp in hand 1. To facilitate passage to Operator A's clamp, tension must be applied to the free end of the ligature. This imparts stability and linearity to the ligature so that it may be efficiently maneuvered into the jaws of Operator A's clamp. This requires that Operator B employ hand 2 which had previously been retracting other organs to provide exposure, suctioning blood from the operative field, or performing other vital functions. Tension may be applied to the free end of the ligature by a third Operator but this is cumbersome because he or she is often removed from the operative field with a poor view. If no tension is applied to the free end of the limp ligature passage is uncertain and cumbersome and Operator A must search for the free end of the ligature to complete the ligation.
Another disadvantage of the current system is that the jaws of Operator B's clamp must be placed beneath Operator A's clamp so that the ligature may be passed. This can be difficult because of space constraints and frequently requires additional dissection. Structures underlying the vessel to be divided may be injured by Operator B's clamp.
I described, by way of example, two changes in the design of the ligature which eliminate the problems detailed above.